"For me it's about representing the 749,000 people I was elected to represent," Meadows told CNN in his small Capitol Hill office. He said his constituents want him to fight against the Affordable Care Act "regardless of consequences."
Meadows represents a conservative constituency. He was elected in 2012 and succeeded Democrat Heath Shuler, who decided not to run for reelection after the latest round of redistricting made the district swing heavily Republican.
Meadows won by 15 percentage points. Republican presidential candidate Mitt Romney won the district with 61 percent of the vote, an impressive outcome in a state he won by 1 point.
But there's more to the story. Meadows works very closely with the tea party groups and he is a conduit to their agenda.
In fact, his catapult from local businessman to elected official was launched with the help of local tea party groups. He underwent a vigorous interview process with the North Carolina-aligned tea party groups that included an intense vetting and interviewing process.
Jane Bilello, head of the Asheville, N.C., tea party group and its separate political action committee, said it is to ensure candidates "truly represents who we are and what we want them to do."
Bilello is pleased with Meadows' job performance so far. She said Meadows is "turning out to be our poster boy."
On the issue of the Affordable Care Act, "he truly represents us," Bilello said.
Well-funded national tea party-aligned organizations, such as Freedom Works, are also watching closely.
Like Bilello's organization, they hold lawmakers accountable. Not only do they keep scorecards of how lawmakers vote on legislation, they are keeping track of what letters they sign on to and their role in every step of the legislative process.
Republican leaders are well aware of the influence of these organizations.
Republican Rep. Lee Terry of Nebraska, who was elected in 1998 and finds himself between the new generation of tea party-aligned groups and the more traditional Republican leadership, said the tea party groups "impacts everybody."
Billelo said that Meadows hosts conference calls with the groups' members to explain what's happening in Congress, including the challenges that he faces promoting their agenda.
She said he told them he's "persona non grata" around the halls of Congress. Bilello said she and her members remind him: "They don't elect you. We do." They also offer assurance: "We have your back. We will support you," Bilello said she tells him.
Meadows relayed a similar sentiment. "There's nobody in Washington, D.C., who ever voted for me and there's no one in Washington, D.C., who will ever vote for me," Meadows said. "So it's about representing the people back home."
The non-leadership leader
"I think everybody wants me to pick a fight with leadership," Meadows said. But he contended that he isn't about playing the rebel, but finding results.
Are his tactics working? Meadows said yes.
"The Senate for the first time is having to vote ... on Obamacare," Meadows said. "That's why we had to do this."
The House has now voted 42 times on either defunding or repealing all or parts of the Affordable Care Act.
Many Republicans in the Senate thought the idea was a lost cause, including Texas Republican John Cornyn, who said Friday that the strategy "won't work."
The Senate eliminated the health care portion of the bill on Friday before sending a revised spending plan back to the House for consideration over the weekend. A shutdown would occur Tuesday, if there is no spending plan in place.
But Meadows successfully convinced a reluctant Boehner to go along with his plan. And then after it became clear the Senate wasn't going to play ball, the speaker hoped to move past the fight and pass a funding bill that would be able to pass the Senate, meaning it wouldn't defund health care.
But Boehner's Republican caucus, once again with Meadows in the forefront, rejected that plan.
Boehner's now working on a plan that will appease members such as Meadows.